Moments of care

By Val Kavanaugh, RDH, Delta Dental of South Dakota (This blog was originally posted by Delta Dental of South Dakota)

One of those moments.

Every hygienist has them. A young man you’ve been seeing for a good number of years is in your chair, and you’re at a loss for words because what you see is so disappointing.

Plaque so thick it peels off. Some of it is orange and some is the consistency of cottage cheese. Every tooth. Every surface. Decalcification ringing every tooth. Red, angry gums just screaming at you. You feel like an utter failure.

He’s a young man now and while scaling, your brain tries to think of words and an approach that will reach him but won’t nag, harp, or belittle him. All while dealing with your own emotions over the situation.

I remember this young man as a child with his beautiful curly hair, energetic personality, and killer smile. And I remember telling him about his killer smile and how to keep it healthy. Repeatedly. What I see right now is soul-crushing. So, nine years later, my tactics to educate are different.

I don’t know a 14-year-old alive that likes to be confronted eye-to-eye, so I begin to talk quietly while I’m still scaling, and I speak from the heart. “I don’t know if you remember me, but I sure remember you. And I remember saying to you several times over the years what a killer smile you had. Well, I can’t say that anymore. Because it no longer is.”

He didn’t move and behind the dark protective glasses, I couldn’t see his eyes. But I kept scaling and talking.

In addition to clinical care, Val provides oral health instruction and information, like explaining to teenagers how much sugar is in what they commonly drink. 

“I’ve talked to you all these years about what it takes to keep a smile healthy and have given you the tools and the knowledge you need. You’re 14 now and I’m not going to lecture you on things you already know, but I am disappointed. And sad. Sad because after four decades of doing this, I know the road you are going down. You just had fillings done because your teeth hurt from cavities because you’re not taking care of them. If things don’t change, this will go on and on, over and over, until you lose your teeth. And at this rate you won’t have any by the time you’re 40.”

I knew he was listening, so I continued. “I used to joke with you and your classmates that if you don’t brush your teeth I’d come to your home and do it for you. Well, you and I both know that I can’t really do that. What happens to your smile is in your hands. It is totally, 100% up to you. And it’s not too late to turn it around.”

I work within schools and with COVID-19, the classrooms are currently virtual. This school let us use a classroom to set up, and families brought their children to us for care. When I finished, we called his grandmother to let him know he was done. She picked him up and left but said she would return when I finished treating her granddaughter.

When Grandma returned, she came inside to use the facilities, and I had a chance to speak with her about his appointment and what was said. She had a light bulb moment and laughed. She said she knew something had happened because she took him to the store and for the first time she could remember, he got a bottle of Vitamin Water instead of a Dr. Pepper.

I could see him through the window and there he was, in the car drinking a bottle of Vitamin Water. I wanted to go hug him but, you know, he’s a 14-year-old. So, I’ll be proud of him from a distance. He took a very small step today, but he took it in the right direction.

That was one of those moments. The good ones.

Val Kavanuagh, RDH, is a dental hygienist for Delta Dental of South Dakota’s Mobile Program. She provides care to kids in community-based clinics and with our mobile dental trucks when they are in western South Dakota. She’s written previously about her experience on the DDSD blog and was featured in a video about the program.